The introduction of a hematoma or fibrin clot is an initial and essential phase in wound repair. The fibrin clot provides a matrix scaffold as well as a chemotactic stimulus to the various cellular elements involved in wound repair. Usually the hematoma or fibrin clot is a naturally occurring sequel in injury to vascular tissue. However, this fibrin clotting is absent in most injuries to articular cartilage and meniscus such as that found in knee, hip and elbow joints. Clinical and experimental observations have shown that meniscal tissue is capable of repair when exposed to vascular (bleeding) tissues and a recent study discusses the three primary avenues that have been used to date to improve the blood supply. These include resecting the peripheral white rim back to a bleeding capsular bed, using a biopsy needle to create radial perforations in the meniscus and using an arthroscopy rasp to abrade the superior and inferior parameniscal synovium to increase blood supply to the meniscal tear. These procedures have all been met with varying degrees of success with the use of the arthroscopic rasp providing the best results. See disclosure by C. E. Henning, M. A. Lynch and J. R. Clark, " Vascularity for Healing of Meniscus Repairs", The Journal of Arthroscopic and Related Surgery 3(1), 13-18 (1987).
Additionally, however, it has been determined that the insertion of an exogenous fibrin clot into the seam of a meniscal tear in dogs will aid in the healing of the articular cartilage and meniscus as disclosed by S. P. Arnoczky, C. A. McDevitt, R. F. Warren and J. Spivak, "Meniscal Repair Using an Exogenous Fibrin Clot--An Experimental Study in the Dog", Orthop. Transactions 1986:10:327-8. However, the viscosity of a fibrin clot is very thick. The material is gel-like and will not flow by itself. Therefore it is very difficult to place a bead of the fibrin clot material into a wound site during an arthroscopic operation. Known medical devices are not suitable or adaptable for use in the vicinity of an articulate joint to deposit a fibrin clot into an articulate joint area.
U.S. Pat. No. 3,506,008 issued to Huck shows a reuseable medical applicator which utilizes an internal rubber plug as an ejector. The plug does not extend beyond the body section such that a significant amount of medicament is left in the applicator even after the plug has been fully seated within the applicator body.
U.S. Pat. No. 3,823,715 issued to Holanek et al discloses a suppository introducer which is used to inject an extrudable material into an open orifice of the human body. The introducer is loaded through its front or small diameter opening. Once the device is inserted into the body, the material is then forced outwardly back through the front opening by a piston. No provision is made to provide a material collection area and the limit of travel of the plunger is controlled to prevent the piston from extending out of the front portion of the introducer.
In the above mentioned medical devices the particular placement of the medicament is not critical to the use of the device. However, often times in medical surgery the placement of the medicament within the patient is critical.
Accordingly, one of the objects of the present invention is to produce a fibrin clot delivery device which can precisely and easily place a fibrin clot material into a wound site during an arthroscopic surgery operation.
It is another object to produce a fibrin clot delivery device which is capable of placing a continuous bead of fibrin clot material into a wound site.
Still another object is to produce a fibrin clot delivery device which is small in size and able to work well in confined spaces such as found during a normal arthroscopic surgical operation.
A further object is to provide a fibrin clot delivery device which includes a collection chamber and a graduated ejection chamber such that the amount of fibrin clot material to be inserted can be premeasured before insertion of the device into the wound site.
Yet another object is to produce a fibrin clot deliery device which deposits a bead of fibrin clot material into a wound site without the material clinging to the end of the device.
It is a further important object of the present invention to provide a method of using fibrin delivery device to place a bead of gel-like material into a wound site through small slits made in the skin of a human body as performed during an arthroscopic surgical operation.
Another object of the present invention is to provide a method of depositing a fibrin clot material into a wound site which method involves steps that may be precisely, easily and safely carried out by a physician using one hand during an arthroscopic operation without the necessity of subjecting the patient to a major surgical operation.